The help clients need in order to stay at home or at a residential facility comes in the form of "home health aides" or "personal and home care aides." While these two occupations are separated in our employment data, they are very similar in duties and work environment, so much so that they will be discussed together and referred to as "aides" throughout much of this article.
The duties of an aide resemble those of anyone caring for an ill family member. They provide companionship and help with daily tasks such as laundry, shopping, dishes, and making beds. They may also provide health services, working under doctors', nurses' or therapists' orders, such as checking temperature and respiration or taking a pulse, all the while keeping records of their daily activities and interactions with clients so they can report on their client's condition.
For most aides, job duties generally include both health care assistance and taking care of household duties. They monitor and assist the client with their health needs while also helping take care of everyday activities. They may assist the same client day after day, or visit multiple clients each day. Part-time work is commonplace for aides.
Although the job duties resemble those of caring for an ill family member, many factors aides are exposed to depend on their client's situation. They may work with children or the elderly. They may be exposed to an array of diseases, such as Alzheimer's or heart disease, or they may work with terminal patients. And preparing meals for nonfamily members can be challenging.
Emotional demands are high as well. Workers spend significant time with their clients, some of whom have mental health issues. They get to know them and get close to them and their families. Clients need the services of aides because they cannot care for themselves, due to disabilities or ailments. Becoming a companion to clients in their situation can be emotionally draining. Job retention is an issue in this field because of this and other factors.
Earnings for aides range from minimum wage (currently $8.80 in Oregon) up to $14 to $16 an hour for experienced workers. The 2011 average (median) in Oregon is $10.02 for home health aides and $10.64 for personal and home care aides.
Job prospects are generally good around the state in this large field. More than 16,500 aides were working in 2010 and that number is expected to jump to more than 22,400 by 2020. That's a healthy 36 percent growth rate, much faster than the 18 percent rate expected for all occupations. Aging baby boomers and a desire to remain at home rather than enter a residential care facility are likely fueling this demand. In addition, the lower costs associated with a home stay over a hospital or residential facility stay is appealing to both clients and insurance companies.
Over the next decade, nearly 8,000 aide job openings are expected in Oregon. Three out of four of those openings will be due to new businesses opening or expanding. The remaining 2,000 will be due to the need to replace workers who move on to other occupations, retire, or leave the labor force. The high physical and emotional demands can take a toll on workers, and worker turnover is common. Patients may not be able to move easily on their own, requiring aides to transfer them from place to place, or stabilize them as they walk. Aides actually have a higher than average number of work-related injuries and illnesses. Working with clients unable to care for themselves can pull on emotional strings.
Home health aides, those performing medical related job duties, must be certified as a nursing assistant to work in Oregon, though those who work for individuals in private homes do not need certification. The Oregon Association for Home Care developed the Home Health & Hospice Aide Certification as a standard for the industry. The exam tests basic competencies of individuals trained in accordance with the Oregon Nursing Practice Act to work as nursing assistants.
Some employers require workers to be a CNA (certified nursing assistant) when applying for jobs as aides. They want them to have some medical background. Others require workers to become a CNA after being hired.